摘要
目的总结枕骨、枢椎椎弓根钉棒系统或寰枢椎椎弓根钉棒系统固定用于治疗上颈椎损伤的效果。方法对16例上颈椎损伤患者术前常规行颅骨牵引复位。术中寰枢椎椎弓根的进钉点选择在寰椎后结节中点旁开18—20mm、后弓上缘下4mm交点处。矢状面上螺钉向头侧倾斜约5°。冠状面垂直。枢椎进钉点为枢椎关节突根部中点，钉道与矢状面夹角为20°-25°，与横断面夹角30°-35°。椎弓根螺钉φ3．5mm，寰椎、枢椎椎弓根螺钉长24—28mm，术中遇阻力大时随时调整方向。结果平均手术时间110min。术前Frankel分级C级1例，D级4例，术后均恢复至E级。随访6—38个月，16例全部植骨融合，内固定无松动。结论枕骨、寰枢椎椎弓根螺钉固定融合治疗上颈椎损伤是一种新技术，具有固定牢固、固定节段短和三维固定的优点。
Objective To investigate the effects of occipital and axoid transpedicle screw-rod fixation and atlantoaxial transpedicle screw-rod fixation for the treatment of upper cervical injury. Methods 16 cases with upper cervical injuries were enrolled. Pre-operative skull traction was performed. The screw insertion point was the intersection of the longitudinal line 18 -20 mm lateral to the center of posterior atlas tuberosity and the horizontal line inferior to the upper margin of posterior arch for atlas, and the trajectory was 5°caudal incline of the screw head in sagittal plane and perpendicular in coronal plane. The screw insertion point was the midpoint of the base of axial articular process for axis, and the trajectory was 20°- 25°caudal incline of the screw head in sagittal plane and 30°- 35°medial incline in coronal plane. The screws were φ 3.5 mm and 24 - 28 mm long for atlas and axis. The trajectory was adjusted when significant resistance was -felt during screw processing. Results The operation time was 110 min on average. 1 cases of Frankel grade C and 4 grade D were recovered to grade E. All cases were followed up for 6 - 38 months. All got bony fusion. No instrument looseness was found. Conclusions It is a new technique for the treatment of upper cervical injury with occipital, atlantoaxial transpedicle screw-rod fixation, which provides rigid, short-segmental and 3 dimensional fixation.
出处
《临床骨科杂志》
2007年第2期97-99,共3页
Journal of Clinical Orthopaedics
关键词
寰椎
枢椎
椎弓根螺钉
骨折固定术
内
颈椎/损伤
atlas
axis
pedicle screw
fracture fixation, internal
cervical vertebrae/injuries
